Personal Care at Home Bill

I will speak to Amendment 47, which stands in my name and is grouped here. In doing so, I thank the noble Baroness, Lady Thornton, for her efforts to ensure that Members of this House had copies of the draft regulations and the consultation paper on draft regulations. There is something fundamental in those documents which led me to table Amendment 47, which asks for there to be a review not within a year of the Bill being implemented, but within six months. The reason for that is that I think noble Lords have overlooked something fundamental. We have made an assumption about the eligibility for this provision; we have assumed that it will make free personal care widely available to many people. I am not sure that that is true. It depends entirely on the answer to one question, which I want to put to the Minister. Pages 14 and 15 of the consultation document about the regulations helpfully set out two things side by side. One is the FACS "critical" criteria band; the other is the list of activities in daily living with which people must have problems to be eligible. It is quite clear from the activities of daily living that someone must have problems with four of them. However, in the FACS "critical" band, the wording is not clear. The criteria for the critical band are as follows; I apologise for reading them out briefly. Somebody’s needs are deemed to be critical when: ""Life is, or will be, threatened and/or … Significant health problems have developed or will develop … Serious abuse or neglect has occurred or will occur … There is, or will be, little or no choice and control over vital aspects of the immediate environment … There is, or will be, an inability to carry out vital personal care or domestic routines … Vital involvement in work, education or learning cannot or will not be sustained … Vital social support systems and relationships cannot or will not be sustained and/or … Vital family and other social roles and responsibilities cannot or will not be undertaken"." How many of those criteria must a person fulfil to be eligible? This is the curse of the bullet point; it is not clear. It mentions these criteria but says "and/or". Is it two? Let us presume that it is two. Is it three? Is it four? That, in conjunction with somebody having to have problems with four ADLs, means that somebody must be very, very ill and restricted in their ability to live to be eligible for this. That makes a huge difference to all the assumptions that underlie the Bill. It could be that in six months’ time it is quite evident, after the implementation of the Bill, that the criteria have been drawn so narrowly that it is not delivering personal care to anyone, or to anything like the number that had been assumed. In which case, I assume, the Government would quickly want to rectify that. Equally, in six months, if this legislation is enacted, word may go around like wildfire that free personal care is available, at which point thousands and thousands of people who self-fund present themselves for assessment. In either of those two cases, that means that this legislation would be wrong. Therefore, it seems to me that within six months we can begin to tell whether it is appropriate or not. The critical question that I want to ask the noble Baroness is how many of those criteria does one have to fulfil? From that we can work out what the impact is likely to be both in budgetary terms and the likely impact on social services departments, which the noble Lord, Lord Best, set out so eloquently.